| NPI | 1154571164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09263200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301097628) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2013-08-25 |